Capitol Hill Report: A Crumbling Foundation

May 26, 2009

The mission of the Academy is to be "indispensable to its members." One way the Academy fulfills this mission is by representing of neurology in the halls of Congress. Capitol Hill Report presents regular updates on legislative action and how the AAN ensures that the voice of neurology is heard on Capitol Hill. The Academy's legislative counsel in Washington, DC, Mike Amery, offers weekly updates on advocacy for neurology and neurologic concerns.

With health reform ideas moving in the House and Senate, physician groups are increasingly concerned that Congress does not intend to eliminate the failed Medicare Sustainable Growth Rate system, which calls for cuts to physician reimbursement and threatens patient access to care every year.

The health care divide between Democrats and Republicans continues to center on whether a public plan option for insurance will be offered. I met with several members of Congress this week—the battle lines were clearly drawn. It is clearly the top concern for both parties. The best examples of this were my conversations with House Energy & Commerce Health Subcommittee members. Jan Schakowsky (D-IL) said a public plan is vital to ensuring that all Americas have access to health care. Meanwhile, Republican Whip Eric Cantor (R-VA) asked for Academy support in killing any reform package with a public plan, because he believes it is the first step toward a single-payer health care system.

The problem with all of this is that Congress lacks focus on the major concern of physicians and the patients who rely on them for care. Physicians face a 21 percent cut in Medicare reimbursement on January 1, 2010, and no one is talking about how to eliminate that and all of the other cuts scheduled behind it on a permanent basis. Not only that, but many of the health reform plans involve an expansion of the health care system on the Medicare model. In other words, building the health care system on what is a crumbling foundation.

Members of Congress are counting on physician support for health care reform. Physicians are counting on Congress to eliminate the SGR. At some point the plan is going to hit the table—if SGR reform isn't there, will physicians oppose reform? Tough decisions are on the way.